小牛血去蛋白提取物对急性脑梗死患者神经功能、认知障碍以及预后的影响

Effects of Deproteinized Calf Blood Extract on Neurological Function,Cognitive Impairment and Prognosis in Patients with Acute Cerebral Infarction

目的探讨急性脑梗死治疗中应用小牛血去蛋白提取物(DCBE)对于患者神经功能、认知障碍以及预后的影响。方法将92例急性脑梗死患者按随机数表法分为对照组(46例)和DCBE组(46例),对照组采用常规治疗,DCBE组联合应用DCBE,疗程2周,治疗后随访1年,比较2组患者神经功能损伤(NIHSS量表)、认知障碍(MMSE和MoCA评分)、抑郁状态(BDI评分)、生活能力(Barthel量表评分)、生活质量(SS-QOL评分)、预后(改良Rankin量表评分)以及不良反应发生率。结果与治疗前相比,2组患者治疗后的NIHSS评分均显著降低(P<0.05);其中DCBE组治疗7d和90d后的NIHSS评分明显低于对照组(P<0.05或P<0.01)。治疗前,2组的MMSE评分、MoCA评分和BDI评分比较差异均无统计学意义(P>0.05);治疗后,对照组的MMSE评分和MoCA评分明显降低(均P<0.01),BDI评分明显升高(P<0.05),而DCBE组治疗前后的MMSE评分和MoCA评分差异无统计学意义(均P>0.05),治疗后的BDI较治疗前明显降低(P<0.05);与对照组相比,DCBE组治疗后的MMSE评分和MoCA评分升高(均P<0.05),而BDI评分降低(P<0.01)。2组治疗后90d的mRS≤2的比例比较差异无统计学意义(P>0.05),DCBE组治疗后1年的mRS≤2比例明显高于对照组(76.09%比52.17%,P<0.05);DCBE组治疗后90d和1年的Barthel指数和SS-QOL评分均明显高于对照组(P<0.05或P<0.01)。对照组和DCBE组的总不良反应发生率比较差异无统计学意义(P>0.05)。结论在急性脑梗死患者治疗中应用DCBE能够显著改善患者的神经功能损伤,减轻认知障碍和抑郁程度,提高患者的生活能力、生活质量和预后。

Objective To investigate the effects of deproteinized calf blood extract(DCBE)on neurological function,cognitive impairment and prognosis in patients with acute cerebral infarction.Methods A total of 92 patients with acute cerebral infarctionwere randomly given conventional therapy alone(control group,46 patients)or in combination with DCBE(DCBE group,46 patients)for 2 weeks.After 1-year follow-up,the scores of neurological function impairment(NIHSS),cognitive impairment(MMSE and MoCA),depression status(BDI),living ability(Barthel scale),quality of life(SS-QOL)and prognosis(modified Rankin scale)and the incidence of adverse reactions were compared between the two groups.Results NIHSS score significantly decreased after treatment in both groups,and the score in DCBE group was lower than that in control group after treatment for 7 and 90 days(P<0.05 or P<0.01).There were no statistical differences in MMSE,MoCA and BDI scores between the two groups before treatment(P>0.05).After treatment,MMSE and MoCA scores decreased but BDI score increased in control group(P<0.05 or P<0.01).In DCBE group,BDI score decreased but no changes in MMSE and MoCA scores were found after treatment(P>0.05).Compared with control group,MMSE and MoCA scores increased but BDI score decreased in DCBE group after treatment(P<0.05 or P<0.01).There was no significant difference in 90-day mRS≤2 ratio between the two groups(P>0.05).However,the 1-year mRS≤2 ratio in DCBE group was higher than that in control group(76.09% vs 52.17%,P<0.05).Furthermore,Barthel index and SS-QOL score in DCBE group were higher than those in control group 90 days and 1 year after treatment(P<0.05 or P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion DCBE treatment can improve neurological function,reduce cognitive impairment and depression,and improve the ability to live,quality of life and prognosisin patients with acute cerebral infarction.